Question 25
A 47 year old veterinarian from Texas arrives at ER with history of low grade fever and cough. He has been having flu like symptoms for the past few days, and non productive cough since three days. He does not remember of being exposed to cases of TB and his last PPD test done 2 months back was negative. He also complains of myalgias and headaches since three days which was relieved with Acetaminophen. On Chest X ray, the physician finds patchy interstitial infiltrates. On chest auscultation, air entry is equal bilaterally and few rhonchi are heard which are scattered. The patient does not look toxic. He has not lost weight recently, and has not experienced any loss of appetite or night sweats. The liver is mildly enlarged and otherwise all examination is unremarkable. What is the vector involved in transmitting the pathogen causing the symptoms?
A) Tse-Tse Fly
B) Wood Tick
C) Dog Tick
D) Rat Tick
E) Body Louse
F) Lone Star Tick
G) No vector involved
Answer will be posted under the Comments section.
1 comments:
Answer: G) No Vector Involved.
This patient most likely is suffering from Atypical Pneumonia.
(Flu like symptoms, CXR s/o patchy interstitial infiltrates...).
The organism causing the symptoms in this patient is most likely Coxiella Burnetti, the only Rickettsia without a vector.
Points to Note:
Coxiella Burnetti: Rickettsia transmitted without a vector.
Seen in Dairy farmers, Veterinarians.
Atypical Pneumonia, Myocarditis, and granulomatous hepatitis.
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